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General NPI Number Information
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NPI Number | 1902450661
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Entity Type | Individual
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Provider Name | DOROTHY ISIDOR PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 2984 ALAFAYA TRL STE 1030
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City | OVIEDO
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State | FL
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Zip | 32765-7628
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Country | US
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Telephone | 407-542-3137
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Fax |
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Provider Business Mailing Address
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Address Line | 13431 CARROWAY ST
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City | WINDERMERE
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State | FL
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Zip | 34786-7344
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Country | US
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Telephone | 321-947-6159
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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